Surgical instrument

ABSTRACT

A surgical instrument is provided. The surgical instrument includes a housing. The surgical instrument includes an elongated portion extending distally from the housing and defines a longitudinal axis. An end effector operably couples to the elongated portion. A first pivoting member pivotably couples to a distal end of the elongated portion. The first pivoting member defines a first pivot axis intersecting the longitudinal axis when the first pivoting member is rotated. A distal mounting assembly pivotably couples to the first pivoting member and operably couples to the end effector. The distal mounting assembly defines a second pivot axis intersecting the first pivot axis and the longitudinal axis when the proximal mounting assembly is rotated.

BACKGROUND

1. Technical Field

This application relates to surgical instruments, and more particularly,to surgical instruments configured to articulate.

2. Background of Related Art

Surgical instruments configured to articulate are well known in themedical art. For example, one type of surgical instrument includes anend effector configured for articulation and configured to join tissue(e.g., surgical stapler, electrosurgical forceps, or other suitabledevice). Typically, such surgical instruments include a shaft extendingfrom a handle and/or trigger assembly, an end effector assemblyincluding a pair of opposing jaw members, and an approximation mechanismfor approximating the jaw members. In some instances, a drive or knifebar (or other suitable device) operably couples to a knife blade and,collectively, are configured to sever tissue that has been joined (e.g.,stapled and/or sealed). Typically one or both of the jaw members isadapted to receive the knife blade within a knife channel operablydisposed on one or both of the opposing jaw members.

In the instance where the surgical instrument is a surgical stapler, oneof the jaw members may support an anvil assembly and the other jawmember may support a cartridge assembly. In certain instances, a knifeblade is translatable through a respective knife channel operablydisposed with each of the anvil and cartridge assemblies. In someinstances, the surgical stapler may be adapted to connect to a loadingunit (e.g., disposable loading unit (DLU) or single use loading unit(SULU)) that includes an end effector assembly, which includes anvilassembly and a cartridge assembly for supporting a plurality of surgicalfasteners.

In the instance where the surgical instrument is an electrosurgicalforceps, one or both of the jaw members may support a seal plate. Incertain instances, a knife blade is translatable through a respectiveknife channel operably disposed with each of opposing jaw members.

There may exist one or more practical challenges associated withsurgical instruments that include articulation devices configured torotate of one or more components (e.g., an end effector) associated withthe surgical instruments. More particularly, the range of motion (e.g.,amount of rotation) associated with the articulation device may belimited. This limited range of motion of the articulation device mayinhibit and/or prevent the end effector and/or jaw members associatedtherewith from functioning in a manner as intended. That is, the jawmembers of the end effector may not properly and/or effectively grasptissue, which, in turn, may result in the jaw members providing aneffect to the grasped tissue that is less than desirable, e.g., anincomplete formation of ejected staples within tissue, an incompleteseal of tissue, etc. In addition, the limited range of motion of thearticulation device results in a radius of curvature adjacent thearticulation device that is relatively small when the end effector is inan articulated position, such as, for example, when the en effector isrotated at an angle of 45°. Thus, in the instance where a drive or knifebar is required to push a knife blade, the small radii of curvatureadjacent the articulation device may cause permanent knife bardeflection.

SUMMARY

According to an aspect of the present disclosure, a surgical instrumentconfigured to surgically join tissue is provided. The surgicalinstrument includes a housing. The surgical instrument includes anelongated portion extending distally from the housing and defines alongitudinal axis. An end effector operably couples to the elongatedportion. A proximal mounting assembly pivotably couples to a distal endof the elongated portion. The proximal mounting assembly defines a firstpivot axis intersecting the longitudinal axis. A stationary gear isprovided and is coupled to the elongated portion so that the proximalmounting portion is pivotable with respect to the longitudinal axis. Adistal mounting assembly pivotably couples to the proximal mountingassembly and couples to the end effector. A movable gear is coupled tothe end effector, the distal mounting assembly being pivotable withrespect to the proximal mounting assembly. An articulation member iscoupled to the proximal mounting assembly so that movement of thearticulation member pivots the proximal mounting assembly and the distalmounting assembly with respect to the longitudinal axis.

In an embodiment, the movable gear is in operative engagement with thestationary gear. At least one link may be provided to operably couplethe proximal mounting assembly to the distal mounting assembly. The atleast one link is pivotably connected to the elongated portion.

In an embodiment, the stationary gear is formed on a pivot plate coupledto the elongated portion. At least one link may couple the proximalmounting assembly to the distal mounting assembly, a proximal portion ofthe at least one link being movable within an arcuate recess formed inthe pivot plate.

In an embodiment, rotation of the proximal mounting assembly in aclockwise direction, and the interaction between the stationary gear andthe movable gear, causes rotation of the distal mounting assembly in theclockwise direction.

In one particular embodiment, the end effector includes a first jawmember and a second jaw member, the first jaw member and second jawmember being movable from an open position wherein the jaw members aredisposed in spaced relation relative to one another, to a clampingposition wherein the jaw members are in an approximated positionrelative to one another.

In one particular embodiment, the end effector includes a staplecartridge assembly and an anvil assembly.

According to an aspect of the present disclosure a loading unitconfigured for use with a surgical instrument is provided. A firstpivoting member pivotably couples to the loading unit. The firstpivoting member defines a first pivot axis intersecting a longitudinalaxis defined by the loading unit. A second pivoting member pivotablycouples to the first pivoting member and operably couples to an endeffector associated with the loading unit. The second pivoting memberdefines a second pivot axis that moves from a position aligned with thelongitudinal axis to a position offset from the longitudinal axis whenthe first pivoting member is rotated. A movable interface between thefirst pivoting member and the second pivoting member.

In an embodiment, a stationary gear is coupled to a proximal end of theloading unit. In an embodiment, a movable gear couples the secondpivoting member to the end effector, the movable gear in operativeengagement with the stationary gear and forms the movable interface.

In an embodiment, rotation of the first pivoting member in a clockwisedirection, and the interaction between the stationary gear and themovable gear, causes rotation of the second pivoting member in theclockwise direction.

In one particular embodiment, the end effector includes a first jawmember and a second jaw member wherein the first jaw member and secondjaw member are movable from an open position wherein the jaw members aredisposed in spaced relation relative to one another, to a clampingposition wherein the jaw members are approximated relative to oneanother.

In one particular embodiment, the end effector includes a staplecartridge assembly and an anvil assembly.

In a further aspect, a surgical instrument configured to surgically jointissue is provided. The surgical instrument includes a housing. Thesurgical instrument includes an elongated portion extending distallyfrom the housing and defines a longitudinal axis. An end effectoroperably couples to the elongated portion. A first pivoting memberpivotably couples to a distal end of the elongated portion. The firstpivoting member defines a first pivot axis intersecting the longitudinalaxis. A stationary gear is provided and is coupled to the elongatedportion so that the proximal mounting portion is pivotable with respectto the longitudinal axis. A second pivoting member pivotably couples tothe first pivoting member and couples to the end effector. A movablegear is coupled to the end effector, the second pivoting member beingpivotable with respect to the first pivoting member. An articulationmember is coupled to the first pivoting member so that movement of thearticulation member pivots the first pivoting member and the secondpivoting member with respect to the longitudinal axis.

In an embodiment, the movable gear is in operative engagement with thestationary gear. At least one link may be provided to operably couplethe first pivoting member to the second pivoting member. The at leastone link is pivotably connected to the elongated portion.

In an embodiment, the stationary gear is formed on a pivot plate coupledto the elongated portion. At least one link may couple the firstpivoting member to the second pivoting member, a proximal portion of theat least one link being movable within an arcuate recess formed in thepivot plate.

In an embodiment, rotation of the first pivoting member in a clockwisedirection, and the interaction between the stationary gear and themovable gear, causes rotation of the second pivoting member in theclockwise direction.

In one particular embodiment, the end effector includes a first jawmember and a second jaw member, the first jaw member and second jawmember being movable from an open position wherein the jaw members aredisposed in spaced relation relative to one another, to a clampingposition wherein the jaw members are in an approximated positionrelative to one another.

In one particular embodiment, the end effector includes a staplecartridge assembly and an anvil assembly.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the present disclosure are described herein withreference to the drawings wherein:

FIG. 1A is a perspective view of a surgical instrument including aloading unit adapted for use with an articulation assembly in accordancewith an embodiment of the present disclosure;

FIG. 1B is perspective view of an electrosurgical instrument adapted foruse with an articulation assembly in accordance with an embodiment ofthe present disclosure;

FIG. 2A is an enlarged view of the area of the detail in FIG. 1A withthe articulation assembly in a non-articulation condition;

FIG. 2B is a bottom perspective view of the articulation assemblydepicted in FIG. 2A;

FIG. 3 is an enlarged perspective view, with portions broken away, ofthe articulation assembly depicted in FIG. 1A with the articulationassembly in an articulated condition; and

FIG. 4 is an enlarged perspective view, with portions broken away, of adistal portion of a distal mounting assembly of the disposable loadingunit shown in FIG. 1A.

DETAILED DESCRIPTION

Embodiments of the presently disclosed surgical instrument are describedin detail with reference to the drawings, wherein like referencenumerals designate similar or identical elements in each of the severalviews. In the drawings and the description that follows, the term“proximal” refers to the end of the surgical stapling instrument that isclosest to the handle assembly, whereas the term “distal” refers to theend of the surgical stapling instrument that is farthest from the handleassembly. As appreciated by one skilled in the art, the depictedsurgical stapling instrument fires staples, but it may be adapted tofire any other suitable fastener such as clips and two-part fasteners.

FIG. 1A illustrates a surgical instrument 10 with an articulationassembly 100 in accordance with the present disclosure. Briefly,surgical instrument 10 (e.g., a surgical stapler 10) includes a housing12 having a handle assembly 14 and an elongated portion or shaft 16defining a longitudinal axis “A-A”. Handle assembly 14 includes astationary handle member 18, and a movable handle member 20. A rotatablemember 22 is mounted on the handle assembly 14 to facilitate rotation ofelongated portion 16 with respect to handle assembly 14. An articulationlever 24 is also mounted on handle assembly 16 to facilitatearticulation of an end effector 26. The distal end of instrument 10 maybe configured as a loading unit 28 (e.g., a disposable loading unit(DLU) or a single use loading unit (SULU)) that is releasably secured toa distal end of shaft 16. In other embodiments, the jaws of theinstrument are attached to the elongated portion or shaft 16 and areplaceable cartridge is utilized. Loading unit 28 includes end effector26 including a pair of opposing first and second jaw members 30 and 32,respectively, including a respective anvil assembly 30 a having aplurality of staple forming pockets and cartridge assembly 32 a housinga plurality of surgical staples. In embodiments, one or both of thecartridge assembly 28 and anvil assembly 30 may be configured to conductelectrosurgical energy.

For a more detailed description of the operation of surgical instrument10 reference is made to commonly-assigned U.S. Pat. No. 5,865,361 toMilliman et al., the entire contents of which is incorporated herein byreference.

Articulation assembly 100 may be adapted for use with an electrosurgicalinstrument 500, e.g., an endoscopic electrosurgical forceps 500 (FIG.1B). Briefly, the electrosurgical instrument 500 can be any suitabletype of electrosurgical instrument, including but not limited toelectrosurgical instruments that can grasp and/or perform any of theabove mentioned electrosurgical procedures. One type of electrosurgicalinstrument may include an endoscopic electrosurgical forceps 500 asdisclosed in United States Patent Publication No. 2007/0173814 entitled“Vessel Sealer and Divider for Large Tissue Structures,” the contents ofwhich is incorporated in its entirety by reference. A brief discussionof endoscopic electrosurgical forceps 500 and components, parts, andmembers associated therewith is included herein to provide furtherdetail and to aid in the understanding of the present disclosure.

Electrosurgical forceps 500 is shown for use with variouselectrosurgical procedures (e.g., tissue sealing procedure) andgenerally includes a housing 520, a handle assembly 530 that includes amovable handle 540 and a fixed handle 550, a rotating assembly 580, apush button assembly 560, a trigger assembly 570, a shaft 512, and anend effector assembly 600, which mutually cooperate to grasp, seal anddivide large tubular vessels and large vascular tissues. In embodiments,electrosurgical forceps 500 is adapted to connect to an electrosurgicalenergy source 700. Although the majority of the figure drawings depictan electrosurgical forceps 500 for use in connection with laparoscopicsurgical procedures, the present disclosure may be used for moretraditional open surgical procedures or endoscopic procedures.

Stapling instrument 10 and electrosurgical instrument 500 hereinafterwill be collectively referred to as a surgical instrument 10. In thedescription that follows, the articulation assembly 100 will bedescribed in terms of use with a surgical instrument 10 including thecomponents associated with the surgical instrument depicted in FIG. 1A.

Referring now to FIGS. 2A-4, and initially with reference to FIG. 2A, anembodiment of the articulation assembly 100 is shown. In the embodimentillustrated in FIGS. 2A-4, a proximal end of a loading unit 28 isconfigured to releasably secure to a distal end of the elongated shaft14 of the surgical instrument 10 (FIG. 1A).

With continued reference to FIG. 2A, articulation assembly 100 providesincreased articulation of the end effector 26 when compared to currentlyknown articulation assemblies. In addition, the articulation assembly100 provides bending of a knife bar 266 (a portion of which is shown inFIG. 4, for example) along a larger radius of curvature, thus minimizingthe stress on a knife bar 266, which, in turn, impedes and/or preventspermanent deflection of the knife bar 266.

Articulation assembly 100 includes a proximal mounting assembly 102 anda distal mounting assembly 104 operably coupled to each other by atleast one link, such as a pair of links 106 a and 106 b (see FIG. 2A incombination with FIG. 2B).

Proximal mounting assembly 102 defines a first vertical pivot axis “B-B”through the proximal mounting assembly (see FIG. 3, for example) andincludes a pivoting member 150 rotatable from about 0° to about 45°, orabout 90°, on either side, off of the longitudinal axis “A-A”, see FIG.3, for example. Pivoting member 150 includes proximal and distal endsthat operably communicate with one or more components associated withthe loading unit 28 and the distal mounting assembly 104. Moreparticularly, pivoting member 150 includes a generally circumferentialconfiguration having arcuate proximal and distal ends 154 and 152,respectively, that facilitate rotation of the pivoting member 150 aboutaxis B-B and with respect to a distal end 42 of the loading unit 28 andthe distal mounting assembly 104 (see FIG. 2A or 2B and FIG. 3). Moreparticularly, distal end 152 includes a radius of curvature of suitableproportion for transitioning the pivoting member 150, and/or otheroperative components associated with the proximal mounting assembly 102,from a non-articulated position to an articulated position (see FIG. 2Ashowing the non-articulated position and see FIG. 3 showing thearticulated position). Pivoting member 150 includes an arcuate or convexproximal end 154 also having a radius of curvature of suitableproportion for transitioning the pivoting member 150, and/or otheroperative components associated with the proximal mounting assembly 102,from a non-articulated position to an articulated position (see FIG. 2Ain combination with FIG. 3). An elongated groove or channel 156 ispositioned alongside of the pivoting member 150. In the embodimentillustrated in FIGS. 2A and 3, the elongated channel 156 extends along aright side of the pivoting member 150 between a proximal and distal face122 and 124, respectively, of the pivoting member 150. Alternatively,the elongated channel 156 may be positioned along a left side of thepivoting member 150. Elongated channel 156 is proportioned to receive adistal end of an articulation member 128, which may be configured as arod, strap, cable, or other member. One or more structures, e.g., apivot pin (not explicitly shown), operably associated with the pivotingmember 150 and positioned in the elongated channel 156, couples to thedistal end of the articulation rod 128. For a more detailed descriptionof the articulation member, reference is made to U.S. Pat. No. 5,865,361to Milliman et al.

Proximal mounting assembly 102 couples to distal end 42 of the loadingunit 28. More particularly, pivoting member 150 is mounted between upperand lower pivot plates 108 a and 108 b, respectively, such that thepivoting member 150 is rotatable relative to each of the upper pivotplate 108 a and lower pivot plate 108 b, and the distal end 42 of theloading unit 28. The upper and lower pivot plates 108 a and 108 b,respectively, are identical to each other, thus, and unless otherwisenoted, only the operative features of the upper pivot plate 108 a willbe described herein. Upper pivot plate 108 a includes an elongatedproximal end 116 a that tapers proximally and fixedly attaches to thedistal end 42 of the loading unit 28. In the embodiment illustrated inFIGS. 2A-3, at least a portion of the proximal end 116 a fixedlyattaches to the distal end 42 of a shaft of the loading unit 28 viawelding, one or more rivets, adhesive, or other attachment method. Upperpivot plate 108 a extends distally toward the end effector 26 anddefines a stationary gear. The stationary gear can be configured as acurved or circumferential distal end 110 a having a plurality of teeth112 a that are configured to mesh or engage with a correspondingplurality of teeth 118 a associated with the distal mounting assembly104 (as best seen in FIG. 3). Upper pivot plate 108 a is stationary inthat upper pivot plate 108 a remains parallel to the longitudinal axis“A-A” during rotation of the proximal mounting assembly 102 (see FIG. 2Ain combination with FIG. 3). One or more pivot pins 120 (or othersuitable structure) is operably associated with the proximal mountingassembly 102 and pivotably couples the pivoting member 150 to respectiveupper and lower pivot plates 108 a and 108 b. More particularly, thepivot pin 120 extends from an upper face 122 of the pivoting member 150through the upper pivot plate 108 a and to a corresponding link 106 a(FIG. 2A). Likewise, a pivot pin 120 extends from a distal face 124 ofthe pivoting member 150 through the lower pivot plate 108 b and to acorresponding link 106 b (FIG. 2B). Upper pivot plate 108 a includes anarcuate or concave recess or slot 114 a operably disposed adjacentproximal end 116 a of upper pivot plate 108 a. Slot 114 a is configuredand proportioned to house a proximal portion of a corresponding link 106a, to be described in greater detail below. Slot 114 a providesadditional structural integrity to and a smooth transition for theproximal mounting assembly 102 when the components of the proximalmounting assembly 102 are rotated.

As noted above, an articulation member 128 is operably associated withthe loading unit 28. More particularly, the articulation member 128 isin mechanical communication with the articulation lever 24. Articulationmember 128 couples to the pivoting member 150 of the proximal mountingassembly 102 and controls the rotation of the proximal mounting assembly102. In the embodiment illustrated in FIGS. 2A and 3, the articulationmember 128 extends along a length of the loading unit 28 from a proximalend where the loading unit 28 couples to a distal end of the surgicalinstrument 10 to the distal portion 42. For a more detailed descriptionof the structural and functional features of articulation rod 128, andoperative components associated therewith, reference is again made toU.S. Pat. No. 5,865,361 to Milliman et al.

Distal mounting assembly 104 defines a second vertical pivot axis “C-C.”The distal mounting assembly includes a pivoting member 160 rotatableabout the axis C-C so that the pivoting member 160 articulates withrespect to the longitudinal axis (FIG. 3). Pivoting member 160 includesa proximal end that operably communicates with the pivoting member 150of proximal mounting assembly 102. More particularly, pivoting member160 includes a generally curved or circumferential configuration havingan arcuate proximal end 164 that facilitates rotation of the pivotingmember 160 with respect to the longitudinal axis. More particularly,proximal end 164 includes a radius of curvature of suitable proportionfor transitioning the pivoting member 160, and/or other operativecomponents associated with the distal mounting assembly 104, from anon-articulated position to an articulated position (see FIG. 2A incombination with FIG. 3).

In the embodiments illustrated in FIGS. 2A-3, the distal end 152 ofpivoting member 150 and proximal end 164 of the pivoting member 160 areconfigured as complementary surfaces. Thus, in an embodiment, the distal152 of pivoting member 150 may include a convex configuration andproximal end 164 of the pivoting member 160 may include a concaveconfiguration. Other complementary surfaces are contemplated and withinthe purview of the present disclosure.

Distal mounting assembly 104 operably couples to the end effector 26 ofthe loading unit 28. In the embodiment illustrated in FIGS. 2A-4, distalmounting assembly 104 is rigidly attached to a proximal end of the anvilassembly 30 a associated with the first jaw member 30 (see FIG. 4, forexample). More particularly, pivoting member 160 is rigidly attached tothe anvil assembly 30 a between upper and lower pivot plates 162 a and162 b (see FIGS. 2A and 2B in combination with FIG. 4). The upper andlower pivot plates 162 a and 162 b, respectively, are identical to eachother, thus, and unless otherwise noted, only the operative features ofthe upper pivot plate 162 a will be described herein. Upper pivot plate162 a includes an elongated distal end 166 a that extends distally andfixedly attaches to the anvil assembly 30 a of the loading unit 28 byany suitable methods and/or structures. In the embodiment illustrated inFIGS. 2A, 3 and 4, upper pivot plate 162 a is monolithically formed withthe proximal end of the proximal end of the end effector. Alternatively,the upper pivot plate 162 a may couple to the anvil assembly 30 a bywelding, one or more rivets, adhesive, or the like. Upper pivot plate162 a is in general alignment with and extends proximally toward thecorresponding upper pivot plate 108 a associated with the proximalmounting assembly 102. The upper pivot plate 162 a defines a movablegear configured as a generally curved or circumferential proximal end165 a having a plurality of teeth 118 a that is configured to mesh orengage with the corresponding plurality of teeth 112 a associated withthe stationary gear of the proximal mounting assembly 102. Upper pivotplate 162 a is movable in that upper pivot plate 162 a is not parallelwith respect to the longitudinal axis “A-A” during rotation of theproximal mounting assembly 102 and the distal mounting assembly 104 (seeFIG. 2A in combination with FIG. 3). One or more pivot pins 120 (orother suitable structure) is operably associated with the distalmounting assembly 104 and pivotably couples the pivoting member 160 torespective upper and lower pivot plates 162 a and 162 b. Moreparticularly, the pivot pin 120 extends from an upper face 168 of thepivoting member 160 through the upper pivot plate 162 a and to acorresponding link 106 a (FIG. 2A). Likewise, a pivot pin 120 extendsfrom a lower face 170 of the pivoting member 160 through the lower pivotplate 162 b and to a corresponding link 106 b (FIG. 2B).

A pair of links 106 a and 106 b operably couples the proximal mountingassembly 102 and distal mounting assembly 104 to each other. Links 106 aand 106 b are identical to each other, thus, and unless otherwise noted,only the operative features of the link 106 a will be described herein.Link 106 a is of rigid construction and operably couples the proximaland distal mounting assemblies 102 and 104, respectively, to each othervia the pivot pins 120, see FIGS. 2A and 2B. A proximal end 180 a of thelink 106 a is movable within the corresponding slot 114 a. Moreparticularly, a finger portion 182 a movably passes through the slot 114a such that the link 106 a may be rotated from either side of thelongitudinal axis “A-A,” see FIG. 2A in combination with FIG. 3, forexample. The proximal end of the link 106 a passes through the slot 114a and is connected to the pivoting member 150, and the lower link issimilarly connected.

In operation, both the proximal pivoting member 150 and the distalpivoting member 160 rotate with respect to the longitudinal axis. Themovement of the proximal pivoting member 150 drives the movement of thedistal pivoting member 160. The links 106 a and 106 b are rigidlyconnected with the proximal pivoting member 150 and rotate with respectto the plates 108.

In other embodiments, the concave/convex surfaces on the proximalpivoting member 150 and distal pivoting member 160 are relied upon todrive the rotation of the distal pivoting member. In embodimentsincluding the gears on the pivot plates, the relative movement betweenthe proximal and the distal pivot members depends on the gear ratio. Forexample, a proximal pivot plate with 28 gear teeth and a distal pivotplate with 20 gear teeth have a gear ratio of 1.4. The gear ratio isused to produce a greater degree of articulation for the end effectorfor the degree of movement of the proximal pivot member.

Turning now to FIG. 4, in an embodiment, loading unit 28 includes anaxial drive assembly that includes an elongated drive beam or knife bar266 including a distal working head 268 defined by a vertical supportstrut that supports or incorporates a knife blade 280. Knife bar 266 maybe constructed from a single sheet of material or multiple stackedsheets. Knife blade 280 is positioned to translate slightly behind anactuation sled (not shown) through a central longitudinal slot incartridge assembly 28 a, and drive the sled forward when the movablehandle of the housing is actuated. The actuation sled, as disclosed inMilliman, et al., U.S. Pat. No. 5,865,361, which is incorporated byreference herein in its entirety, has angled surfaces for camming staplepusher. As the staple pushers are disposed in the staple cartridge sothat they support surgical staples, the forward movement of the sled(which is driven by the knife bar 266) cams the staple pushers upwardlydriving the staples against an anvil surface of the anvil assembly. Inthis way, surgical staples are placed in, and formed in tissue, whilethe blade 280 divides the tissue.

The knife bar 266 is relatively flexible so that, when the instrument 10is fired in the articulated position, the knife bar 266 bends. In thiscase, the knife bar 266 bends around both of the pivots 120. A pair ofblow out plates 255 are positioned on either side of the pivots 120,extending from one end of the articulation assembly 100 to the other endof the articulation assembly, to prevent outward bulging of the driveassembly, e.g., the knife bar 266, during articulation and firing oftool assembly 20. In certain embodiments, a pair of blow out plates 255are positioned on either side of the proximal pivot 120 and another pairof blow out plates are positioned on either side of the distal pivot120.

Reference is again made to FIG. 2A in combination with FIG. 3. Inoperation, the proximal mounting assembly 102 functions as anarticulation multiplier when the proximal mounting assembly 102 isrotated. That is, rotation of the pivoting member 150, in combinationwith the links 106 a and 106 b and the gears associated with each of theproximal and distal mounting assemblies 102 and 104, respectively, causethe distal mounting assembly 104 including the pivoting member 160 and,thus, the end effector 26 to pivot about the proximal mounting assembly102 and/or the pivoting member 150. As can be appreciated by one ofskill in the art, the links 106 a and 106 b in combination with the gearconfigurations associated with each of the proximal and distal mountingassemblies 102 and 104 function not unlike that of a planetary gearsystem. The gear ratio between the gears of the proximal and distalmounting assemblies 102 and 104, respectively, determines the amount ofrelative motion between the proximal and distal mounting assemblies 102and 104, respectively. More particularly, a high gear ratio provides ahigh degree of relative rotation between the respective proximal anddistal mounting assemblies 102 and 104, while a low gear ratio providesa low degree of relative rotation between the respective proximal anddistal mounting assemblies 102 and 104. In the embodiment illustrated inFIGS. 2A-3, the proximal and distal mounting assemblies 102 and 104,respectively, include a 1:1 gear ratio.

In use, the articulation lever 24 is rotated by the user of theinstrument, in the direction of directional arrow E (FIG. 1A). Rotationof articulation lever 24 translates the articulation member 128 in aproximal direction. This movement of the articulation member 128 rotatesthe proximal mounting assembly 102 around the associated pivot 120 andin the direction of directional arrow F (FIG. 3). The interactionbetween the stationary gear and the movable gear causes the distalmounting assembly 104 and, thus, the end effector 26 to rotate off thelongitudinal axis A-A, in the direction of directional arrow G (FIG. 3).Accordingly, the amount of articulation that the end effector 26 iscapable of achieving is increased when compared to an amount ofarticulation that known end effectors are capable of achieving. Moreparticularly, known end effectors are capable of articulating an amountthat is approximately equal to the amount of articulation that pivotingmember 150 of proximal mounting assembly 102 is capable of pivoting. Inaccordance with the present disclosure, and as noted above, rotation ofthe pivoting member 150, in combination with the links 106 a and 106 band gear configurations associated with each of the proximal and distalmounting assemblies 102 and 104, respectively, cause the pivoting member160 and, thus, the end effector 26 to pivot an additional amount aboutthe proximal mounting assembly 102 and/or the pivoting member 150. As adirect result thereof, the amount of articulation that end effector 26is capable of achieving is increased, which, as can be appreciated byone of ordinary skill in the art may provide a user with a bettermechanical advantage when manipulating tissue of interest. Either theconfiguration of the cooperating surfaces on the pivoting member 150 andpivoting member 160, or the gears (or other cooperating shape on thepivoting plates) can be relied upon to produce the articulating movementof the distal pivoting member 160. Further, in other embodiments, thearticulation member can be arranged to move distally in order to producethe articulating movement.

From the foregoing and with reference to the various figures, thoseskilled in the art will appreciate that certain modifications can alsobe made to the present disclosure without departing from the scope ofthe same. For example, in an embodiment, the gear configurations of eachof the proximal and distal mounting assemblies 102 and 104,respectively, may be configured to cause the proximal and distalmounting assemblies 102 and 104, respectively, to move in oppositedirections. That is, one of the mounting assemblies (e.g., mountingassembly 102) may be configured to rotate in the direction ofdirectional arrow F, i.e., clockwise, while the other mounting assembly(e.g., mounting assembly 104) may be configured to rotate in a directionopposite that of directional arrow G, i.e., counter clockwise. Inembodiments, a third gear is disposed between the stationary gear andthe distal movable gear, mounted in the middle of the link 106. Thiswould result in the distal pivot member rotating in the oppositedirection of the proximal pivot member.

While several embodiments of the disclosure have been shown in thedrawings and/or discussed herein, it is not intended that the disclosurebe limited thereto, as it is intended that the disclosure be as broad inscope as the art will allow and that the specification be read likewise.Therefore, the above description should not be construed as limiting,but merely as exemplifications of particular embodiments. Those skilledin the art will envision other modifications within the scope and spiritof the claims appended hereto.

1. A surgical instrument comprising: a housing; an elongated portionextending distally from the housing and defining a longitudinal axis; anend effector operably coupled to the elongated portion; a proximalmounting assembly pivotably coupled to a distal end of the elongatedportion, the proximal mounting assembly defining a first pivot axisintersecting the longitudinal axis; a stationary gear coupled to theelongate portion, the proximal mounting assembly being pivotable withrespect to the stationary gear; a distal mounting assembly pivotablycoupled to the proximal mounting assembly and coupled to the endeffector, the distal mounting assembly defining a second pivot axis; amovable gear coupled to the end effector, the distal mounting assemblybeing pivotable with respect to the proximal mounting assembly; and anarticulation member coupled to the proximal mounting assembly so thatmovement of the articulation member pivots the proximal mountingassembly and the distal mounting assembly with respect to thelongitudinal axis.
 2. A surgical instrument according to claim 1,wherein the movable gear is in operative engagement with the stationarygear.
 3. A surgical instrument according to claim 1, wherein at leastone link operably couples the proximal mounting assembly to the distalmounting assembly.
 4. A surgical instrument according to claim 3,wherein the at least one link is pivotably connected to the elongatedportion.
 5. A surgical instrument according to claim 1, wherein thestationary gear is formed on a pivot plate coupled to the elongatedportion.
 6. A surgical instrument according to claim 5, wherein at leastone link couples the proximal mounting assembly to the distal mountingassembly, a proximal end of the at least one link being movable withinan arcuate recess formed in the pivot plate.
 7. A surgical instrumentaccording to claim 1, wherein rotation of the proximal mounting assemblyin a clockwise direction, and the interaction between the movable gearand the stationary gear, causes rotation of the distal mounting assemblyin the clockwise direction.
 8. A surgical instrument according to claim1, wherein the end effector includes a first jaw member and a second jawmember, the first jaw member and the second jaw member being movablefrom an open position wherein the jaw members are disposed in spacedrelation relative to one another, to a clamping position wherein the jawmembers are approximated relative to one another.
 9. A surgicalinstrument according to claim 8, wherein the end effector includes astaple cartridge assembly and an anvil assembly.
 10. A loading unitconfigured for use with a surgical instrument, the loading unitcomprising: a first pivoting member pivotably coupled to the loadingunit, the first pivoting member defining a first pivot axis intersectinga longitudinal axis defined by the loading unit, the first pivot axisbeing aligned with the longitudinal axis; a second pivoting memberpivotably coupled to the first pivoting member and operably coupled toan end effector associated with the loading unit, the second pivotingmember defining a second pivot axis that moves from a position alignedwith the longitudinal axis to a position offset from the longitudinalaxis when the first pivoting member is rotated; and a movable interfacebetween the first pivoting member and the second pivoting member.
 11. Aloading unit according to claim 10, further comprising a stationary gearcoupled to a proximal end of the loading unit.
 12. A loading unitaccording to claim 11, further comprising a movable gear coupling thesecond pivoting member to the end effector of the loading unit, whereinthe movable gear is in operative engagement with the stationary gear andforms the movable interface.
 13. A loading unit according to claim 12,wherein rotation of the first pivoting member in a clockwise direction,and the interaction between the stationary gear and the movable gear,causes rotation of the second pivoting member in the clockwisedirection.
 14. A loading unit according to claim 10, further comprisingan articulation member coupled to the first pivoting member so thatmovement of the articulation member pivots the first pivoting member andthe second pivoting member with respect to the longitudinal axis.
 15. Aloading unit according to claim 10, wherein the end effector includes afirst jaw member and a second jaw member, the first jaw member and thesecond jaw member being movable from an open position wherein the jawmembers are disposed in spaced relation relative to one another, to aclamping position wherein the jaw members are approximated relative toone another.
 16. A loading unit according to claim 15, wherein the endeffector includes a Staple cartridge assembly and an anvil assembly. 17.A surgical instrument comprising: a housing; an elongated portionextending distally from the housing and defining a longitudinal axis; anend effector operably coupled to the elongated portion; a first pivotingmember pivotably coupled to a distal end of the elongated portion, thefirst pivoting member defining a first pivot axis intersecting thelongitudinal axis; a stationary gear coupled to the elongate portion,the first pivoting member being pivotable with respect to the stationarygear; a second pivoting member pivotably coupled to the first pivotingmember and coupled to the end effector, the second pivoting memberdefining a second pivot axis intersecting the longitudinal axis; amovable gear coupled to the end effector and the second pivoting member;and an articulation member coupled to the first pivoting member so thatmovement of the articulation member pivots the first pivoting member andthe second pivoting member with respect to the longitudinal axis.
 18. Asurgical instrument according to claim 17, wherein the movable gear isin operative engagement with the stationary gear.
 19. A surgicalinstrument according to claim 17, wherein at least one link operablycouples the first pivoting member to the second pivoting member.
 20. Asurgical instrument according to claim 19, wherein the at least one linkis pivotably connected to the elongated portion.
 21. A surgicalinstrument according to claim 17, wherein the stationary gear is formedon a pivot plate coupled to the elongated portion.
 22. A surgicalinstrument according to claim 21, wherein at least one link couples thefirst pivoting member to the second pivoting member, a proximal end ofthe at least one link being movable within an arcuate recess formed inthe pivot plate.
 23. A surgical instrument according to claim 17,wherein rotation of the proximal mounting assembly in a clockwisedirection, and the interaction between the movable gear and thestationary gear, causes rotation of the second pivoting member in theclockwise direction.
 24. A surgical instrument according to claim 17,wherein the end effector includes a first jaw member and a second jawmember, the first jaw member and the second jaw member being movablefrom an open position wherein the jaw members are disposed in spacedrelation relative to one another, to a clamping position wherein the jawmembers are approximated relative to one another.
 25. A surgicalinstrument according to claim 24, wherein the end effector includes astaple cartridge assembly and an anvil assembly.